Effect of preterm premature rupture of membranes on umbilical artery Doppler indices

Objective

One of the importatnt aspect of PPROM is subclincal infection and metabolic response of fetus to this infection. Response of fetus to this subclinical infection is know as FIRS( Fetal Inflammatory Response Syndrome) (1). As a result of FIRS there is detoriation in the cardiac function in fetus (2). In the case of pprom there is also detoriation in umblical and splenic artery Doppler indices(3,4). It has been shown that after amnioinfusion there has been improvement in umblical artery Doppler indices. As a result of subclical infection and mechanical effect of fetus to amniotic vasculature there might be new vascular adaptaion and organization in umblical artery. In our study we examine effect of pprom on umbilical artery doppler indices.

Methods

This was a case control study that was designed in Etlik Zubeyde Hanım Women’s Health and Tranining Research Hospital between January 2013 and July 2013. Cases were formed from the 42 patient that have the diagnosis of PPROM and control group formed from 58 pregnancy week matched healthy pregnant. Study group were formed from the pprom patient under 34 week of pregnancy without any know intrauterine growth restriction, clinical chorioamnionitis,olygohydramnios. Umbilical arter resistance and A/B indices were collected from the last measurement before the birth

Results 

When compared with control group there was no differences in umbilical artery resistance and pulsality indices in study group (p=0.402, p=119) Table 1. When the effect of duration of PPROM on umbilical artery Doppler indices evaluated, PPROM patient divided in to two group according to median value of pprom duration. The duration of PPROM have no effect on umbilical artery Doppler indices

Conclusion

Preterm premature rupture of membranes have no effect on umbilical artery hemodynamic indices. Resistance indices and systole/diastole ratio did not diifer between study and control group. Yuce at al showed that in the cases of histological chorioamnionitis umbilical artery resistance increased(3). In our study we did not do subgroup analysis that compares subclinic chorioamnionitis with control group. In the case of subclinical chorioamnionitis this finding could be changed. There is need to be RCT trail to show exact effect of pprom on hemodynamic parameters of fetal circulation

Keywords

PPROM, umbilical lartey